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Enterocytozoon bieneusi is an obligate intracellular parasitic fungi that infects a wide range of mammalian hosts. However, the literature is lacking information regarding the presence and diversity of E. bieneusi genotypes in domesticated dogs in Northwestern China. Fecal samples from 604 pet dogs were obtained in 5 cities (Urumqi, Korla, Hotan, Aksu, and Shihezi) in Xinjiang. Screening for E. bieneusi was performed, and isolates were genotyped via nested-PCR amplification of the internal transcribed spacer (ITS) of nuclear ribosomal DNA. The infection rate of E. bieneusi was 6.3% (38/604). The prevalence of E. bieneusi infections in adult animals (>1 year, 10.3%, 15/145) was higher than that in younger (≤1 year) dogs (5.0%, 23/459), which was statistically significant (p = 0.021). No significant difference was observed between the different collection sites or between sexes. Eight distinct genotypes were identified, including 5 known genotypes (PtEb IX, EbpC, D, CD9, and Type IV) and 3 novel genotypes (CD11, CD12, CD13). The most prevalent was genotype PtEb IX, being observed in 50.0% (19/38) of the samples, followed by EbpC (31.6%, 12/38), D (5.3%, 2/38), and the remaining genotypes (CD9, Type IV, CD11, CD12, and CD13) were observed in 1 sample (2.6%, 1/38) each. These findings suggest that genotypes PtEb IX and CD9 are canine host-adapted, and likely pose little risk of zoonotic transmission. Moreover, known zoonotic genotypes EbpC, D, and Type IV represent a public health concern and should undergo further molecular epidemiological investigation.
This post-hoc analysis characterized the weekly incidence and overall duration of common early-onset treatment-emergent adverse events (TEAEs) during solriamfetol treatment.

Participants (obstructive sleep apnea [OSA], N=474; narcolepsy, N=236) were randomized to 12 weeks of placebo or solriamfetol 37.5 (OSA only), 75, 150, or 300 mg. For common early-onset TEAEs (those occurring in ≥5% of participants in any solriamfetol dose group and with a higher incidence than that observed in placebo-treated participants during week 1), the incidence of new occurrence or change in severity over time was calculated for each subsequent study week. Data were analyzed separately for each study and summarized by placebo and combined solriamfetol groups.

Common early-onset TEAEs (at doses ≤150 mg, ie, approved doses) included headache (OSA, 5.1%; narcolepsy, 8.5%), nausea (OSA, 2.5%; narcolepsy, 4.2%), decreased appetite (OSA, 4.2%; narcolepsy, 5.9%), as well as anxiety (2.1%), insomnia (1.3%), and feeling jittery (3.0%) in OSA and dry mouth (4.2%) in narcolepsy. Incidence of common early-onset TEAEs was highest at week 1 and decreased over time. In OSA at doses ≤150 mg, headache, nausea, and feeling jittery had median durations ≤8 days, whereas decreased appetite, anxiety, and insomnia had longer durations. In narcolepsy at doses ≤150 mg, headache and nausea had median durations ≤8 days, whereas decreased appetite and dry mouth had longer durations. Most TEAEs were mild to moderate in severity.

Common early-onset TEAEs with solriamfetol are limited in duration, with the majority subsiding during the first week of treatment.

NCT02348593; NCT02348606.
NCT02348593; NCT02348606.Eye diseases are an important group of increasingly prevalent disorders that contribute very significantly to disability and represent a considerable health burden. Some data suggest that several of these diseases may be associated with sleep-disordered breathing, mainly obstructive sleep apnea (OSA), due to intermediate mechanisms, such as intermittent hypoxia or sleep fragmentation. The aims of this systematic review were to identify and critically evaluate the current evidence supporting the existence of a possible relationship between OSA and the more relevant eye diseases as well as to evaluate the potential pathogenic mechanisms. There is a body of largely low level evidence for the association of OSA with glaucoma, nonarteritic ischemic optic neuropathy, central serous chorioretinopathy and diabetic retinopathy. Meta-analysis of available case-control studies shows that OSA increases the risk of glaucoma (pooled odds ratio 1.50; 95% confidence interval 1.25 to 1.80; p less then 0.001), nonarteritic ischemic optic neuropathy (3.62; 1.94 to 6.76; p less then 0.001) and diabetic retinopathy (1.57; 1.09 to 2.27; p=0.02). Moreover, several pathogenic pathways have been identified, mainly related to hypoxic damage, mechanical stress, systemic inflammation, oxidative stress, sympathetic tone and endothelial dysfunction. In contrast, information about the effect of apnea-hypopnea suppression on the development and progression of eye damage is either non-existent or of a very low level of evidence. In conclusion, OSA has emerged as an additional potential risk factor for many eye diseases, although their link is weak and contradictory, so further examination is required.
In Portugal, a colorectal cancer screening program based on faecal immunochemical test followed by colonoscopy was shown to be cost-effective for individuals between 50 and 74 years old. We report the first findings of the implementation of a population-based program In Northern Portugal.

In the pilot phase, eligible subjects were allocated either to a direct mailing invitation or to primary care centers. Proteasome activity In the first year of program implementation, we assessed the uptake rate, the faecal immunochemical test -positivity rate, the diagnostic yield of advanced neoplasia, and the quality parameters for post-faecal immunochemical test + colonoscopy.

We invited 100 501 eligible subjects (49% male with a median age of 55 years). Of these, 5228 participated in the pilot phase and 95 273 participated in the first year of the program. In the first year of the program, the adherence was 29%, with a positivity rate of 5% and a 60% compliance to colonoscopy. The faecal immunochemical test-detection rate of advanced neoplasia was 0.35/1000 subjects, and the positive predictive value at post- faecal immunochemical test + colonoscopy was 44% and 2% for advanced adenoma and invasive cancer, respectively. No major adverse events were reported after colonoscopy.

The suboptimal adherence to faecal immunochemical test and post-faecal immunochemical test + colonoscopy remains the most urgent step to be addressed.

A centralized invitation system based on direct mailing was feasible and both colonoscopy quality and diagnostic yield were adequate antecipating the success of the programme.
A centralized invitation system based on direct mailing was feasible and both colonoscopy quality and diagnostic yield were adequate antecipating the success of the programme.
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